Why Do Some Good Eye Surgeons Not Take Fellowship?

Dec 15, 2011

Glaucoma is a serious eye disease that can lead to blindness. It is therefore best seen and treated by a glaucoma specialist. Among other eye diseases, glaucoma specialists are eye doctors who chose to train specifically in the diagnosis and treatment of glaucoma. It is a glaucoma specialist’s job to lower the pressure inside the eye to prevent the glaucoma patient from going blind, either by prescribing medicines in the form of eye drops, performing laser or any of the different form of glaucoma surgeries.

A glaucoma specialist achieves his or her level of expertise through two avenues of learning. One is through formal two-year glaucoma fellowship training in a medical institution or a teaching hospital. Or second, is by getting hands-on training on a specific glaucoma treatment like laser or canaloplasty for example, or any treatment for that matter.

Because of the number of new technologies in glaucoma treatment now available, glaucoma specialists can stay up to date and train in new glaucoma treatments through other non-fellowship training channels. An eye doctor for example who wants to perform canaloplasty can apprentice under the guidance of a more experienced surgeon. The senior doctor must of course have done a number of the procedures himself and has built a credible reputation for her skill in that area. After the apprentice has mastered or achieved a certain level of competence, she then gets to be certified to do the procedure and offer the service to her own patients.

All glaucoma specialists whether fellowship or non-fellowship trained are expected to perform traditional glaucoma surgery called trabeculectomy. However, this kind of filtering surgery is always reserved for complicated and advanced glaucoma cases. Since the risk for blindness for this is high, it is the fellowship trained glaucoma specialist who gets to perform more of these under a more critical hospital setting.

Thankfully, majority of the glaucomas seen in optometrists or family doctors’ clinics are benign and its early stages like primary angle open glaucoma, which are amenable to medical treatment like eye drops, laser, and other non-invasive forms of surgery like canaloplasty. Moreover, these also do not necessarily require invasive surgery initially. Thus it is a common practice even for non-fellowship trained glaucoma specialists to treat these cases successfully early on before blindness and other complications ensue.

Unlike major eye surgery, an eye doctor or a non-fellow glaucoma specialist can perform a variety of medical or surgical glaucoma treatments at the convenience of his own clinic. It does not take formal fellowship training to do these procedures. In fact, many non-fellow eye doctors and glaucoma surgeons are qualified to do laser or perform the latest procedures in interventional ophthalmology which includes artificial drainage devices, shunts and microcatheter insertions.

In summary, before you consent to glaucoma surgery or treatment for yourself or a loved one’s, it is important that you check your glaucoma specialist’s professional credentials. And although you may encounter two kinds of glaucoma specialists- the fellowship trained and the non-fellowship trained, both are experts in their own field of glaucoma treatment or surgery, and are in no way less skilled than the other. But at the end of the day, it is not a glaucoma specialist’s certificates that matter but his or her true competency for the treatment procedure itself. His or her patients will tell you the real story. Actual patients are most likely to give you an honest assessment of the glaucoma specialist’s skills and quality of service. Here’s a site of Dr. David Richardson where you can watch, listen, and read patients’ success stories: http://david-richardson-md.com/testimonials.

Dr. David Richardson, MD. is a Board-certified Ophthalmologist and Eye Doctor in Los Angeles, California. He is a recognized and respected, cataract and glaucoma surgeon; and is among an elite group of eye surgeon in the country performing the highly specialized canaloplasty procedure.